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Still Smoking After Cancer Diagnosis?


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http://www.pittsburghlive.com/x/pittsbu ... 09746.html


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Paulette Chemelli smoked a pack-and-a-half a day for almost 20 years, and not even cancer could get her to quit cold turkey.

She managed to cut back to four or five cigarettes a day. But the daily ritual and reward of lighting up continued, even as she underwent surgery and chemotherapy in 1985, and was put on oxygen.

"I went to the doctor today and he said my lungs sounded really good," said Chemelli, 59, of Kittanning. "So I come home and what do I do? I have a cigarette."

Among active smokers diagnosed with cancer, about half continued smoking, according to separate surveys of patients through West Virginia University and the University of Pittsburgh.

The WVU study, published in the January edition of the Journal of Oncology Practice, examined patients with several types of cancer. The Pitt study looked a just lung cancer patients -- making the fact that only half quit more surprising, said Stephanie Land, the director of Pitt's Reduce Smoking and Exposure to Tobacco Center, called ReSET.

"Some patients may be so concerned about their diagnosis that they're not emotionally ready to make other lifestyle changes," said Land, an associate professor at Pitt's Graduate School of Public Health.

"It's just that addictive," said Susan Harshbarger, director of smoking-cessation programs at St. Clair Hospital. "It acts on the pleasure centers of the brain, and on the centers that give us a sense of security, a sense of peace."

Because a cancer diagnosis can be so stressful, that kind of effect might be exactly what a newly-diagnosed patient is looking for, she said.

"For the first six to eight months, it really bothered me," said Thomas Brink, 59, of Freeport, who was diagnosed with lung cancer in February 2007. "(Smoking) kept my mind occupied, and when something like this happens, it leaves you with a lot to think about."

Brink never thought his cancer was the result of smoking -- he'd worked at the Braeburn Steel mill in Lower Burrell and blamed his exposure to asbestos there -- but he knew it didn't help his health either.

"The thing about critically ill patients is that a lot of them feel like the damage is already done," said Maryann Valasek, director of tobacco and health programs for the American Respiratory Alliance of Western Pennsylvania. "They say, 'I might as well keep smoking.' "

Chemelli envied people who quit cold turkey, but has noticed that some of the pleasure of her habit dwindled. She used to smoke two cigarettes before bed as a nightly "ritual," but lately found herself lighting up and smoking them quickly "to get it over with," she said.

Tobacco use tends to suppress the effectiveness of radiation and chemotherapy, and increases the chances of complications during surgery, so getting smokers to quit after they're diagnosed with cancer is important, Land said.

Smokers are at a higher risk for developing bronchitis and pneumonia after surgery because of increased mucus production that is a side-effect of smoking, said Dr. Robert Keenan, chief of thoracic surgery at Allegheny General Hospital. Quitting at least several weeks before surgery can significantly decrease risk, he said.

Brink tried and failed to quit many times since taking up smoking at the age of 16, he said. But after his 2007 heart attack led to the discovery that he had Stage 4 lung cancer, the most severe, he set his mind to it and quit just as he started undergoing surgery to remove part of his lung and chemotherapy to attack the tumor.

"I'd tried everything imaginable before that," Brink said. "But it was just a mindset I had to get into."

Doctors are studying University of Pittsburgh Cancer Institute data for any effect that quitting at the time of diagnosis has on recurrence rates, but will not release conclusions for about six months, Land said. In Belgium, a study showed those who quit after diagnosis and beat cancer into remission went longer without recurrence of the disease than those who kept smoking, she said.

The WVU study's authors said fewer than two-thirds of smokers diagnosed with cancer got counseling from doctors on ways to quit, but Land said doctors weren't the only ones who had to support cancer patients trying to stop smoking.

"Many times, a lung cancer patient might want to quit, but if their entire family is smoking around them it makes it more difficult for them to quit," she said.

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(Pittsburg Tribune-Review, Article by Matthew Santoni, February 1, 2009)


The information contained in these articles may or may not be in agreement with my own opinions. They are not being posted with the intention of being medical advice of any kind.

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This is really extremely biased, as all the smoking propaganda is. For someone like me with Stage 4 lc who is not undergoing chemo/rad and who has no breathing problems whatsoever, there is actually less reason to quit smoking now than ever before in my life (and I've been smoking since 11, 54 years ago this coming spring). I no longer travel, I no longer walk my dog, I no longer have anything to look forward to -- smoking is perhaps the greatest pleasure left to me and I shall continue to smoke so long as it is a pleasure. (Yes, I thoroughly enjoy each and every cigarette and always have.)

And, just for the record, my type of cancer is not the kind statistically correlated with smoking.


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Hi Ellen,

I agree with you that if you want to smoke, and you enjoy it, it is your right. No one can force you to give up smoking. It is still a free country.

The article reminded me that I was a smoker, as was Bill, for more than forty years. Bill and I gave it up because we felt like it. That was our choice, and we gave up something that we found to be enjoyable. Why wouldn't we? We were addicted. We had to enjoy it.

At the time of Bill's diagnosis, we had given up cigarettes for five years.

It was a very difficult thing for us to do. We enjoyed smoking very much. It was our addiction of choice.

Who knows if we would have given them up at a later juncture, when Bill was facing Stage IIIB lung cancer. This is something we will never know.

What I am grateful for is that he has had one less thing to interfere with his treatments. It's bad enough to be sitting in a Cancer Center for many, many hours (some regimens) and be without that "security blanket," but to endure that deprivation at that time would have been extremely painful.

I understand where you are coming from, I hear you.

The article wasn't put on the board to give anyone a guilt trip of any kind. I have absolutely no guilt about my having smoked.

My attitude is that people should be free.

One doctor I know thinks that only certain lung cancers are due to smoking. He was the same fellow who waited so long to diagnose Bill's lung cancer that it was almost a year further along.

Wishing you well, Ellen. Please do not be irritated at the messenger? I meant no harm.

Knowledge is power,


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Hi Barbara.

I was in NO WAY irritated at YOU! And I'm really sorry if that was how I sounded! I just get angry at all the anti-smoking literature that throws around 'facts' with no noticeable evidence and pulls numbers out of their you-know-where. The fact is, the number of smokers has dropped precipitously -- and the number of lung cancer cases continues to rise. And they keep extending the time they claim it takes after quitting smoking to cancel the 'danger' -- to the point where the average person won't live long enough to reap the supposed 'benefit'. There's a lot of b.s. out there on this subject but I'll quit ranting for now. I'm really sorry if it sounded as tho I was mad at you.


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It makes me very happy to know that you aren't feeling negative toward me.

The only reason I am here at all is due to my obsession with Bill's cancer. It helps me when I find things that may help somewhat in the information department.

Trust me, I don't advocate all that is in these articles, and I try to remember to put a disclaimer after each article. :D

But, there is an advantage to giving up smoking, or cutting back quite a bit, for those who cannot breath well, and who might be able to get through radiation and chemo a bit better. I do know that it helped Bill. His appetite was amazing - all through the treatments - still is.

For those having surgery, it is very helpful if they have given up smoking quite a bit in advance, according to the stats on mortality.

Two of our four children smoke. It pains me, but I do believe they have that right to choose. I don't hassle them about it. Of course, it bothers me because I don't know if they inherit any genes which influence their susceptibility to lung cancer.

It's all very complicated, but my main hope, Ellen, is that researchers get the funding, work toward a cure and, at least, come up with some decent, less-toxic treatments.

In the meanwhile, I hope you enjoy each day. That's what we try to do, and may we remember that we are all walking this walk together. This journey can be a roller coaster ride.

Ellen, I am glad that we had this chance to "meet." :)


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I met a wonderful man on this board, the man who started "the path less traveled". DeanCarl and I used to speak on the phone for hours at a time. I'm a never smoker, he smoked while he was on oxygen and almost burned his house down...

He said pretty much what you're saying, the only thing he had left was smoking and he wasn't going to give it up now. I got it, I get what you're saying, and if you want to continue smoking, that's your choice.

Be kind to yourself.

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Hi Barbara and Snowflake.

Barbara, I just wanted to say that I read all your news posts and they are among my favorites on this board -- and I fully realize you aren't endorsing them! Thank you for the trouble you go to to find them and post them. Btw, try not to worry too much about your smoking kids -- life is a crap shoot and nobody knows what the future holds. Case in point: my mother, a never-smoker, died at 57 from a tumor in the trachea. There was no autopsy so we never knew if it was malignant or what kind of cancer if it was but I now suspect it was some kind of BAC lung cancer. And my father smoked from age 10 till his death at 83 and never had a trace of lung cancer. (And, no, it wasn't 'second-hand smoke' that killed my mother since my father worked 6 days a week, leaving the house at 7am and returning at 9pm -- he spent very few waking/smoking hours in her presence.) Go figure.

Snowflake, I joined this group near the end of Dean Carl's life and didn't know about his smoking but I related to and agreed with everything else he said. And thank you for your tolerance -- it's much appreciated.


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I will keep in mind what you have said about the "crap shoot." :lol:

Now, when I look at those two "kids," (in their forties), I will think of that and probably it's closer to the truth than anything we have read on the subject.

Thanks for the very friendly repartee.


PS: Just looked out the window and, oh boy, the snow is finally sticking to the sidewalks. Thought we were going to escape it this time. That means we get the shovels, and get out there. When is this weather ever going to change? We just had a reprieve of two warm days. The weather thermometer is now reading 28 degrees. This is ridiculous.

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  • 9 months later...
  • 6 months later...

It is not good to smoke while on chemotherapy. Primarily because your white blood cell count will be lowered during chemo as a result of the chemo. Your body will already be working on over time to repair the damage from the chemo, and the smoking just adds more damage your body is trying to repair. It will make your recovery slower, and it increases your chances of infections. First your immune system will be lower than normal, so it could cause you to get lung infections or sinus infections. And because your body is directing some of its defenses to the damage from the smoke, and its already being damaged by the chemo, it leaves you open to other infections because you are stretching your already low infection fighting resources too thin.

Make sure your docs are aware that you are smoking and make sure you report the first signs of any kind of respiratory infections or other kinds of infections.

It is also found that smoking made the nausea worse, so it may be easier than you think to cut back or even quit right now.




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